High-pitch dual-source CT angiography of the whole aorta without ECG synchronisation: Initial experience

Beeres, Martin; Schell, Boris; Mastragelopoulos, Aristidis; Herrmann, Eva; Kerl, J. Matthias; Gruber‐Rouh, Tatjana; Lee, Clara; Petra, Stefania; Bodelle, Boris; Zangos, Stephan; Vogl, Thomas J.; Jacobi, Volkmar; Bauer, Ralf W.

doi:10.1007/s00330-011-2257-5

Cited by 53 publications

(52 citation statements)

References 16 publications

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“…The median value of CTDI vol from our study was comparable to Christensen et al [5] and Ippolito et al [6] and higher than Zhang et al [7] and Beeres et al [8]. Regarding the DLP, the median value of our study was more or less comparable to Cornea et al [9] and Ippolito et al [6] and higher than Zhang et al [7], Manheimer et al [10] and Beeres et al [8].…”

Section: Resultssupporting

confidence: 82%

“…Regarding the DLP, the median value of our study was more or less comparable to Cornea et al [9] and Ippolito et al [6] and higher than Zhang et al [7], Manheimer et al [10] and Beeres et al [8]. Christensen et al [5] 32x0.6 120 2.4 13.9 -Zhang et al [7] 64x0.6 100 1.2 5.6 191.3 Cornea et al [9] 64x0.625 100 1.375 -648.71 Manheimer et al [10] 64x0.625 120 --325.6 Beeres et al [8] 128x0.6 100 3.0 3.70 273.0 Ippolito et al [6] 128x0 Figure 1. The distribution of DLP values from chest CTA examinations using a 16-slice system.…”

Section: Resultssupporting

confidence: 81%

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Institutional doses for chest CTA examinations using a 16-slice system

Messaris

Panayiotakis

2017

J. Phys.: Conf. Ser.

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Abstract. According to the council directive 2013/59/EURATOM, an important tool for the optimization of the radiation doses delivered to patients is the Diagnostic Reference Levels (DRLs). The Greek Atomic Energy Commission (GAEC) reports the national DRLs, based on institutional dose levels reported from various hospitals. There is a lack of national DRLs regarding various examinations and among them is the Computed Tomography Angiography (CTA). In this work, the dose delivered to patients during chest CTA examinations, at the University Hospital of Patras (UHP), is presented. Thirty standard sized patients were evaluated using a 16-slice CT system. The median value of the volume Computed Tomography Dose Index (CTDIvol) was 12.07 mGy and the median value of the Dose Length Product (DLP) was 429.66 mGy•cm. These values were comparable or higher than the corresponding values of the existing bibliography. The values reported could contribute in the establishment of the national DRLs.

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Section: Resultssupporting

confidence: 82%

Section: Resultssupporting

confidence: 81%

Institutional doses for chest CTA examinations using a 16-slice system

Messaris

Panayiotakis

2017

J. Phys.: Conf. Ser.

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“…This advantage is readily explained by the application of 100 kVp, which is closer to the K-edge of iodine and enables better interaction than higher potentials, such as those used for standard CTA (14). The increased aortic attenuation might contribute to increased diagnostic confidence (e.g., depiction and characterization of parietal thrombus) along with reduction of motion artifacts achieved by the higher temporal resolution (15). Lower kVp can also be used to increase the aortic attenuation, with further reduction in radiation dose and even reduction in volume of contrast agent compared with standard CTA.…”

Section: Discussionmentioning

confidence: 99%

High-pitch dual-source CT angiography without ECG-gating for imaging the whole aorta: intraindividual comparison with standard pitch single-source technique without ECG-gating

Manna¹,

Silva²,

Cobelli³

et al. 2017

Diagn Interv Radiol

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C omputed tomography angiography (CTA) of the aorta is the reference method to investigate aortic disease and to follow up patients after surgical or endovascular aortic repair, either thoracic or abdominal. Thoracic aorta usually demands electrocardiography (ECG)-gated CTA to avoid motion artifacts related to cardiac cycle, notably for imaging aortic root and ascending segment (1). However, ECG-gating results in significantly increased radiation exposure, notably in case of low-pitch acquisition for retrospective reconstruction. Furthermore, ECG-gating technique is also related to significant increase of imaging time and volume of contrast agent.Dual-source (DS) hardware is a significant technological advance because it allows acquisition with exceptionally high-pitch and fast rotation speed, with substantial reduction of acquisition time and time resolution. For instance, DS-CTA with ECG-gating allows whole coronary imaging (scan length, 12-14 cm) in a single heart cycle with significant reduction in radiation dose and volume of contrast agent (2). Furthermore, DS-CTA with ECG-gating provides high quality images with minor motion artifacts also in imaging of whole thoracic aorta (scan length 20-30 cm) (3). Karlo et al. (4) demonstrated that high-pitch DS-CTA without ECG-gating provides diagnostic image quality of the aortic valve-aortic root complex similar to ECG-gated technique. Despite these advantages in acquisition of short vascular segments (e.g., coronary or thoracic aorta), the role of high-pitch DS-CTA in imaging the whole thoracoabdominal aorta still remains a challenge and a topic of debate (5-8) C A R D I O VA S C U L A R I MAG I N G O R I G I N A L A R T I C L E PURPOSEWe aimed to perform intraindividual comparison of computed tomography (CT) parameters, image quality, and radiation exposure between standard CT angiography (CTA) and high-pitch dual source (DS)-CTA, in subjects undergoing serial CTA of thoracoabdominal aorta. METHODSEighteen subjects with thoracoabdominal CTA by standard technique and high-pitch DS-CTA technique within 6 months of each other were retrieved for intraindividual comparison of image quality in thoracic and abdominal aorta. Quantitative analysis was performed by comparison of mean aortic attenuation, noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). Qualitative analysis was performed by visual assessment of motion artifacts and diagnostic confidence. Radiation exposure was quantified by effective dose. Image quality was apportioned to radiation exposure by means of figure of merit. RESULTSMean aortic attenuation and noise were higher in high-pitch DS-CTA of thoracoabdominal aorta, whereas SNR and CNR were similar in thoracic aorta and significantly lower in high-pitch DS-CTA of abdominal aorta (P = 0.024 and P = 0.016). High-pitch DS-CTA was significantly better in the first segment of thoracic aorta. Effective dose was reduced by 72% in high-pitch DS-CTA. CONCLUSIONHigh-pitch DS-CTA without electrocardiography-gating is an effective technique for...

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“…Modern CT technology has achieved such high temporal resolution that scanners can virtually freeze motion for the evaluation of the thoracic aorta without ECG-gating. Third generation dual-source CT allows pitch values of up to 3.4 and motion free images of the aortic root can be acquired with or without electrocardiographic gating (13,14) (Figure 3). Beers at al reported that both ECG-gated and non-ECG-gated high-pitch protocols provide equivalent subjective and objective image quality without motion related artifacts.…”

Section: Whole Body Cta With High-pitch Dual Source Ctmentioning

confidence: 99%